Title 17, Title 17: CORPORATIONS AND INSTITUTIONS FOR FINANCE AND INSURANCE

17:48E-35.8. Benefits for certain cancer treatments 3. In addition to benefits provided under regulations adopted pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.) and P.L.1992, c.162 (C.17B:27A-17 et seq.), a health service corporation shall offer under every group or individual…

17:48E-35.9. Coverage for birth and natal care; health service corporation 3. a. Every individual or group contract that provides maternity benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.) or approved for issuan…

17:48E-36. Annual financial statement a. Every health service corporation transacting business in this State shall annually on or before the first day of March file in the Department of Insurance a statement, subscribed and sworn to by its principal officers, showing its financia…

17:48E-37. Examination authority a. The commissioner shall have the power, whenever he deems it expedient, to make or cause to be made an examination of the assets and liabilities, method of conducting business and all other affairs of every health service corporation authorized …

17:48E-37.1 Definitions. 31. As used in sections 31 through 35 of P.L.2014, c.81 (C.17:48E-37.1 through C.17:48E-37.5): "Commissioner" means the Commissioner of Banking and Insurance. "Health service corporation" means an entity authorized to transact business in this State pursu…

17:48E-37.2 Increase in amount of capital or surplus required of health service corporation. 32. The commissioner may increase the amount of capital or surplus required of a health service corporation, or subsequently revise or redetermine that increase, using appropriate methods…

17:48E-37.3 Determination of increase, revision or redetermination; factors. 33. In determining any increase, revision or redetermination in the capital or surplus of a health service corporation pursuant to the provisions of section 32 of P.L.2014, c.81 (C.17:48E-37.2) the commi…

17:48E-37.4 Suspension, revocation of authority to do business. 34. The commissioner may suspend or revoke the authority to do business in this State of any health service corporation that does not comply with the provisions of sections 31 through 35 of P.L.2014, c.81 (C.17:48E-3…

17:48E-37.5 Rules, regulations. 35. The commissioner may promulgate regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) necessary to effectuate the purposes of sections 31 through 35 of P.L.2014, c.81 (C.17:48E-37.1 through C.17:48E-37…

17:48E-38. Fee schedule A health service corporation shall pay the following fees to the commissioner for enforcement of the provisions of this act: a. For filing its application and charter, $10.00; b. For filing each annual statement, $20.00; c. For each copy of any paper filed…

17:48E-39. Penalties for violations Any health service corporation of this or any other state, country or province which shall have violated any of the provisions of, or shall have neglected, failed or refused to comply with any of the requirements of, this act, except the failur…

17:48E-4. Certificate of authority a. A health service corporation, other than a health service corporation which is formed as the result of a merger of a medical service corporation and a hospital service corporation, which seeks a certificate of authority shall file in the Depa…

17:48E-41. Health service corporation, exemption from taxes A health service corporation subject to the provisions of this act is hereby declared to be a charitable and benevolent institution and all of its funds shall be exempt from every State, county, district, municipal and s…

17:48E-42. For-profit corporations excluded The provisions of this act shall not apply to any corporation carrying on the business of life, health or accident insurance, for profit or gain, or to fraternal beneficiary associations as defined in section 1 of P.L. 1959, c. 167 (C. …

17:48E-43. Subject to review All determinations of the commissioner made under the provisions of this act shall be subject to review by the Superior Court in a proceeding in lieu of prerogative writ. L. 1985, c. 236, s. 43, eff. July 15, 1985.

17:48E-44. Rules, regulations The commissioner, pursuant to the "Administrative Procedure Act," P.L. 1968, c. 410 (C. 52:14B-1 et seq.), shall promulgate rules and regulations as are necessary to effectuate the provisions of this act. L. 1985, c. 236, s. 44, eff. July 15, 1985.

17:48E-45. Definitions relative to conversion > 1. As used in sections 2 through 4 of this act: "Commissioner" means the Commissioner of Insurance. "Conversion" means the conversion of a health service corporation to a domestic mutual insurer in accordance with the provisions of …

17:48E-46. Conversion of health service corporation to domestic mutual insurer 2. A health service corporation which is organized pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.) may convert to a domestic mutual insurer by complying with the provisions of sections 2 through 4 of …

17:48E-46.1. Findings, declarations relative to the reorganization of a health service corporation 1. The Legislature finds and declares that: a. It is in the interest of the subscribers of the health service corporation and the State of New Jersey that the health service corpora…

17:48E-46.10. Plan of dissolution 10. Upon any voluntary dissolution of a mutual holding company in accordance with N.J.S.15A:12-2, 15A:12-3, 15A:12-4, 15A:12-5, 15A:12-6, 15A:12-7, or section 19 of P.L.1992, c.65 (C.17B:32-49), the mutual holding company shall adopt a plan of di…

17:48E-46.11. Annual statements; report to the Governor 11. a. A mutual holding company shall file with the commissioner an annual statement pursuant to applicable laws of this State. b. The mutual holding company shall, on an annual basis, and in a form and manner prescribed by …

17:48E-46.12. Public records 12. a. The application submitted pursuant to section 5 of P.L.2020, c.145 (C.17:48E-46.5) shall be a public record, except for the following documents, which shall be confidential and not public records: (1) documents deemed confidential by statute or…

17:48E-46.13. Initial and annual assessments 13. a. Following regulatory approval pursuant to section 5 of P.L.2020, c.145 (C.17:48E-46.5) and the establishment of a mutual holding company, the mutual holding company, or any affiliates benefiting from the establishment of a mutua…

17:48E-46.14. Mutual holding company 14. A mutual holding company formed pursuant to P.L.2020, c.145 (C.17:48E-46.1 et al.) shall not convert to a for-profit stock holding company. The provisions of P.L.2001, c.131 (C.17:48E-49 et seq.) providing for conversion of a health servic…

17:48E-46.15. Board of the mutual holding company; membership, transitional period, diversity 15. a. The board of the mutual holding company shall be constituted of 22 directors as follows: (1) 13 directors shall be elected, as provided in the bylaws, one of whom shall be the cha…

17:48E-46.16. Full-time employees maintained for 36 months following transition 16. a. Upon the formation of a mutual holding company, the total number of full-time employees that were employed within a mutual holding company system shall be maintained for a transition period of …

17:48E-46.17. Severability 19. a. The provisions of P.L.2020, c.145 (C.17:48E-46.1 et al.) shall be severable; and if any phrase, clause, sentence, or provision is deemed unenforceable, the remaining provisions of P.L.2020, c.145 (C.17:48E-46.1 et al.) shall be enforceable. b. Th…

17:48E-46.2. Definitions relative to the reorganization of a health service corporation 2. As used in P.L.2020, c.145 (C.17:48E-46.1 et al.): "Assessment" means an initial and a limited duration assessment made upon the mutual holding company system pursuant to section 13 of P.L.…

17:48E-46.3. Mutual holding company, not for pecuniary profit, mission 3. a. A mutual holding company organized pursuant to P.L.2020, c.145 (C.17:48E-46.1 et al.) shall not be established as a company organized for pecuniary profit and shall retain the designation as a charitable…

17:48E-46.4. Health service corporation to reorganize into mutual holding company system 4. a. A health service corporation organized pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.) may reorganize to create a mutual holding company system pursuant to a plan of reorganization at …

17:48E-46.5. Health service corporation applicationto form mutual holding company system 5. a. A health service corporation may submit an application to the commissioner to form a mutual holding company system. Upon submission of an application to the commissioner, a health servi…

17:48E-46.6. Monitoring mutual holding company's operations 6. A mutual holding company system shall be considered an insurance holding company system and subject to P.L.1970, c.22 (C.17:27A-1 et seq.). The commissioner shall possess supervisory powers with respect to the insuran…

17:48E-46.7. Investments; supplier program; mutualization; reorganization plans 7. a. A mutual holding company or a non-insurance subsidiary may, alone or together, make any lawful investments including directly or indirectly acquiring or otherwise holding the stock or other owne…

17:48E-46.8. Non-obligation of distribution payment to members, policyholders 8. Neither the adoption nor the implementation of a plan of mutualization and reorganization shall be deemed to give rise to any obligation by or on behalf of any entity in the mutual holding company sy…

17:48E-46.9. Membership in mutual holding company 9. a. Membership in a mutual holding company shall be determined in accordance with the mutual holding company's articles of incorporation and bylaws and may be based upon: (1) the amount of health insurance policies in force with…

17:48E-47. Filing, approval of conversion plan 3. a. Upon the affirmative vote of the board of directors, the plan for conversion to domestic mutual insurer shall be filed with the commissioner for approval. A public hearing thereon shall be held within 30 days after the filing, …

17:48E-48. Directors and officers, terms 4. a. Public members of the board of directors of the health service corporation shall serve as directors of the domestic mutual insurer to the end of the term for which they were appointed and thereafter may be elected as directors of the…

17:48E-49 Definitions relative to conversion of health service corporation to domestic stock insurer. 1. As used in this act: "Affiliate" or "affiliated" has the meaning set forth in subsection a. of section 1 of P.L.1970, c. 22 (C.17:27A-1). "Alternative foundation plan" means t…

17:48E-5. Merger procedure Upon the merger of a medical service corporation into a hospital service corporation, the surviving corporation shall qualify as a health service corporation, and the surviving corporation need not obtain a new charter or certificate of authority to act…

17:48E-50 Procedure for conversion. 2. a. A health service corporation may convert to a domestic stock insurer by complying with the provisions of sections 2 through 14 and section 19 of this act. b. To convert to a domestic stock insurer, the board of directors of a health servi…

17:48E-51 Filing of application. 3. a. The health service corporation shall file with the commissioner an application pursuant to subsection b. of this section for approval of, and permission to convert pursuant to, a plan of conversion. Concurrent with the filing of the applicat…

17:48E-52 Approval of plan, certificate of authority. 4. a. The commissioner shall approve the plan of conversion and issue a certificate of authority to the converted insurer to transact business in this State as a domestic stock insurer only if the commissioner finds all of the…

17:48E-53 Issuance of subsequent order. 5. The order of the commissioner issued pursuant to section 4 of this act shall not take effect unless the commissioner issues a subsequent order finding that: a. the Superior Court has entered an order pursuant to subsection f. of section …

17:48E-54 Transfer of fair market value. 6. a. At or before the effective time, the entire fair market value of the health service corporation, exclusive of any shares of the converted insurer or any parent corporation issued pursuant to subsection e. of this section, shall be tr…

17:48E-55 Continuation of health service corporation. 7. a. The legal existence of the health service corporation shall not terminate, and the converted insurer shall be a continuation of the health service corporation. The conversion shall only be a change in identity and form o…

17:48E-56 Conversion of policies. 8. a. The policies of the health service corporation shall be converted to policies of the converted insurer without any further action on the part of the converted insurer. b. Policies of the health service corporation that were issued and remai…